psychographics + technology - south texas...
TRANSCRIPT
Psychographics + Technology:Changing Patient Behaviors in Cardiovascular Health to Drive Better Outcomes, Productivity and Cost Savings
Pat DunnSr. Program ManagerCenter for Health Technology & InnovationAmerican Heart Association
Brent WalkerSVP Marketing & AnalyticsPatientBond
• Introductions & Objective
• Economic Impact of Cardiovascular Disease
• Heart Failure and the Opportunity for Reducing Hospital Readmissions
• The Role of Psychographic Segmentation and Adaptive Technology
• Case Study: Significantly Reduced 30-Day CHF Readmissions
• Going Forward: Prevention of Disease Progression
• Q&A
Agenda
Economic cost of cardiovascular disease
Total direct and indirect cost of cardiovascular disease is $316 B;
• Direct cost is $189 B
• Cardiovascular disease and stroke account for 14% of total healthcare expenditures;
• More than any other diagnostic group
$16,940
$17,592
$18,234
$19,950
$20,022
$24,381
$25,369
$25,706
$30,073
$34,303
$35,148
$35,584
$36,456
$37,183
$39,287
$41,304
$41,333
$47,229
$59,249
$73,823
$75,906
$83,598
$87,598
$92,137
$100,996
$0 $20,000 $40,000 $60,000 $80,000 $100,000 $120,000
Cerebrovascular disease
Stroke
Other care and screening
Other bone, musculoskeletal
Pneumonia
Infectious diseases
Other circulatory
Upper GI
Residual codes
Kidney disease
Hyperlipidemia
Skin disorders
Systemic lupus/connective tissues
Other CNS
Normal birthlive born
Gall bladder
Back problems
Hypertension
Diabetes
Osteoarthritis
COPD, asthma
Mental disorders
Cancer
Trauma
Heart conditions
Source: National Medical Expenditures Panel, Survey of 2012
Top 25 Diagnoses: average aggregate annual expenditure
: Chronic Disease
Projected cost of cardiovascular disease through 2030
By 2030
• 43.9% of US population will have some form of CVD
• Total cost is projected in increase from $318 B to $918 B
• 60.5% of that is attributed to hospital costs
What is Heart Failure?•Heart failure occurs when the
heart muscle is weakened and cannot pump enough blood to meet the body's needs for blood and oxygen.
•Blood will back up into the lungs, causing shortness of breath, and the legs, resulting in swollen ankles.
A large, and growing population
•6.5 million Americans live with heart failure
•1 million hospital discharges per year
•Expected to grow 46% by 2020 to 8 million
Impact of heart failure
1 year mortality 29.6%
5 year mortality 54-61%
Estimated cost is $30 billion
• 68% of costs are direct medical
30 day readmission rate is 20-25%
The economics of preventing readmissions
Assumptions
• Margins for heart failure are thin
• Resource utilization (costs) are high
• Readmissions are preventable
Preventing a readmission
• Improves quality profile of healthcare system
• Frees up beds and other resources for higher margin patients
• Prevents operating loss on ‘hard to manage’ patients
The economics of preventing readmissions
• Some readmissions are necessary
• Earlier identification decompensated heart failure may result in a shorter length of stay and lower cost of treatment
• Engaging the patient post discharge can result in greater loyalty to healthcare system, resulting in incremental revenue from other healthcare needs (i.e., diagnostics, and procedures).
Heart failure readmission prevention strategy
•Goal: 20% reduction in heart failure readmission rates
•Public reporting of hospital quality, perception, readmission, and mortality
•Readmission penalties
•Get With The Guidelines
2006-2009 readmission rate 20%
2009-2012 readmission rate 19%
1 of 70 hospitals achieved a 20% reduction
How is 20% reduction in heart failure readmission rates strategy working?
5%
•Hospital Compare
2006-2009 readmission rate 24.7%
2009-2012 readmission rate 23.1%
2.6% of hospitals achieved a 20% reduction
6.4%
How is 20% reduction in heart failure readmission rates strategy working?
Science TranslationMulti-disciplinary Professional Education Courses, Scientific Conferences & Events
with reach to global audiences
Diagnosis or Acute Event
Patient Education at Point of Care (Patient TV), Quality &
Systems Improvement programs
Care Transitions Educational tools – print and digital, Support Network, CHTI AHA Inside
Models, Self-Management Platforms
Science Discovery
Strategically Focused Research Networks, My Research Legacy,
Heart & Stroke Registry, Scientific Statements and
Guidelines, Scientific Journals
At HomeMulti-Media Campaigns, Educational
tools – print and digital, Support Network, Self-Management Platforms,
Heart & Stroke Registry, Community Programs, Volunteer Navigators
American Heart Association strategy
AHA CarePlan Solutions
Derived from the evidence based guidelines
What is a CarePlan?
A Care Plan is a way to execute evidence based guidelines.
• Type & frequency of assessmentssuch as electrocardiogram, cardiac enzymes, and blood pressure
•Decision making (and shared decision making) in regards to treatments & interventions such as open heart surgery vs. stent
•Medication management
•Patient & family education
•Coordination of care
CENTER FOR HEALTH TECHNOLOGY & INNOVATION
16
Beyond taking their medications, many patients have questions like to know:
What should I eat?
What are my physical activity limitations?
What are common signs and symptoms?
How do I communicate information to my healthcare team?
17
Yet We Have The Typical Post-Acute Experience
Too much information
Too many choices
Everything is hard
I feel all alone
Who can I trust?
Psychographic Segmentation + Adaptive Technology =
Precision Engagement
Background
Is Education the Answer?
Psychographic Segmentation
AttitudesBeliefsValuesLifestylesPersonalities
Five Healthcare Psychographic Segments
Segment Description Engagement Strategy
Self
Achievers
24%
I take ownership of my health and I actively take steps to
be healthy. I focus on achieving my goals and objectives.
A disease is another challenge to be overcome.
Achieve the goal
Balance
Seekers
18%
I am open to many ideas and options, as long as they
make sense for me. I need context to understand ideas
and recommendations.
Context, Candor and
Choices to be made
Priority
Jugglers
18%
I worry more about my family’s health than my own. I am
constantly on the go, juggling many responsibilities, so
getting sick is not an option.
How the family/others will
benefit;
Commitment & duty
Direction
Takers
13%
I look to my physician and other health care professionals
for guidance and direction on what I need to do to address
my disease.
Doing what I ask of you
Willful
Endurers
27%
There are more important things in my life to focus on than
improving my health. I live in the “here and now”. Living for today
The Segments Are Among Every Population and Health Condition
0%
5%
10%
15%
20%
25%
30%
35%
40%
Gen Pop 18-24 Hispanic Medicaid Uninsured HMO Health
Balance Seekers
Willful Endurers
Priority Jugglers
Self Achievers
Direction Takers
0
10
20
30
40
50
60
70
Total Rep Pneumonia* Chronic
Obstructive
Pulmonary
Disease
(COPD)
Heart Attack/
Failure*
Had A Hip
Replacement
Had A Knee
Replacement
Balance Seekers
Willful Endurers
Priority Jugglers
Self Achievers
Direction Takers
Issues tied to 30 day readmission
PatientBond: Consumer Psychology + Adaptive Technology
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Iwanttopersonallythankyouforbeingapa entatPriorityCare.Asyouprobablyknow,ournumberonegoalhereistoprovidetheabsolutebesthealthcarepossibleinacomfortablese ng.Didyouknowthatnewpa entsgenerallyfindoutaboutourprac cethroughword-of-mouthfrompa entslikeyou?SothatbringsmetoafavorIwouldliketoaskyou.Couldyoupleasetakeafewminutestothinkofsomefriendsandfamilymembersofyourswhomaybelookingforamedicalclinicandletthemknowaboutus?Whetherit'soneperson,tenpeopleorevenmore,yourreferralwouldbegreatlyappreciated.So,pleasefeelfreetointroducethemtoouroffice,andIpromisewewilltakeverygoodcareofthem.Ifyouhaveanyques onsatall,pleasefeelfreetocallusat3124024006.Thankingyouverymuchinadvance!Verytrulyyours,Dr.KalpanaNarangP.S.Thereferralofafriendoralovedoneistheul matecomplimentyoucangiveus.Thanksagain!
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Powered by PatientBond
Email Text Interactive Voice Response
Your Healthcare Consumer Audience
PatientBond segments your patients/consumers
PatientBond modifies patient behavior using a preference based, outbound communications platform
Who?
Why?
What?
How?
Who is this patient
What are they doing?
Why are they doing what
they do?
How should we reach out to
them?
Healthcare focuses here
Psychographics add focus here
• Healthcare historically knows “WHAT” patients are doing • To change behavior you must know “WHY” patients are doing things
Healthcare Behavior Change Foundation
PatientBond executes here
• Large, nonprofit hospital system
• Objectives - Use the PatientBond platform to:
• Primary: Reduce Readmission Rates after CHF Discharge currently at 18.5%
• Secondary: Improve patient experience & engagement while optimizing nurse time
CHF 30 Day Readmissions Reduction Pilot
Discharges by Segment Type
Direc onTaker37%
SelfAchiever31%
PriorityJuggler15%
WillfulEndurer14%
BalanceSeeker3%
Remember, all 5 segments are usually there…just the distribution changes
Communication Sequence Over 30 Days
1 3 5 10 15 20 30
Discharge instructions
and Welcome to 30
day program
How to track recovery
and symptoms
Medication
Adherence
Follow up Appointment
and access questions
Monitoring your
weight
When to seek
medical attention
Your recovery
zone
Salt and Fluid in
your diet
Appointment
Follow Up
Making Changes
in your Diet
Activity, Smoking,
Drinking Tips
Congratulations!
2 4 7 12 17 25
Days after Discharge
Medication Status
& Access
Communications Include Patient Response Prompts
Patients Answer the Five Questions
Patient Response Dashboard
Patient Responses Across Engagement Timeline
Responses By SegmentFTEs WILL MANAGE THE EXCEPTIONS !
• 315 CHF discharges over 5 months
• 90% reduction in 30 days all-cause readmissions (from 18.5% to <2%)
• 62% patient response rate to 14 waves of psychographic communications
• 94% of patients (age 65+) liked the electronic discharge process and digital communications
Results
What is the Opportunity?
Discharges per Month
Current System Readmission Rate
Expected System
Readmissions
ENTERCosts per
ReadmissionExpected
Costs
ENTER Projected Reduction Percentage
Readmission Savings
CHF 30 24% 7 $9,000 $64,000 30% $19,200
AMI 20 20% 4 $5,000 $20,000 30% $6,000
CABG 10 23% 2 $10,000 $20,000 30% $6,000
Mo. Savings $31,200
CONFIDENTIAL
Going Forward: Reducing Disease ProgressionBig Opportunities for Collaboration
Lessons learned?
• Heart failure patient have multiple co-morbidities
• Plan must be personalized, and relevant
• Cannot be one-size-fits-all
38
AHA Inside: Improving health outcomes with personalized, engaging tools
Using a research-based personalized experience helps patients create durable behavior change.
AHA’s Life’s Simple 7TM
the seven most important predictors of heart health
Get Active
Eat Better
Manage Weight
Stop Smoking
Reduce Blood Sugar
Control Blood Pressure
Control Cholesterol
• Connected Heart Health was developed to improve the quality of life for patients by:
• Connecting patients to the healthcare providers, caregivers, and other patients
• Translating the AHA guidelines in easy to understand steps to promote self-care
• Accessing patients education resources, developed by the AHA, designed to improve knowledge, health literacy, and behaviors, leading to improved outcomes
• Sharing patient reported measures with healthcare providers
Meeting People Where They Are
COMMUNITY HEALTHCARE
DAILY LIFE
BROCHURES& KITS
WEBSITES
MULTI-MEDIA CAMPAIGNS
CORPORATE & COMMUNITYPROGRAMS
SUPPORT NETWORK & PREFERENCES
REGISTRYDIGITAL SELF-
MANAGEMENT TOOLS
PATIENT TV
Why patient person centric?
• Person can overcome odds,the disease cannot
• Person:
• Nothing to do with illness and disease
• It is not about disease, it is about life.
“do the things I like to do”
“I want to be happy”
Collaborating in Cardiovascular Disease Prevention
Health Motivation Assessment
(HMA) Sets the Priorities Personalizes Communications
Psychographic SegmentationAHA’sLife’sSimple7TMthesevenmostimportantpredictorsofhearthealth
GetAc ve
EatBe er
ManageWeight
StopSmoking
ReduceBloodSugar
ControlBloodPressure
ControlCholesterol
SelfAchiever
BalanceSeeker
PriorityJuggler
DireconTaker
WillfulEndurer
Glucose
PhysicalAc vity
Nutri on
Weight
Smoking
Cholesterol
BloodPressure
12-52 week program with segment specific messaging & frequency
• Cardiac 30 Day Readmission Reduction programs• Digital discharge management solution aimed at reducing hospital readmissions for
cardiovascular conditions
• Health Enhancement Program• Digital health engagement platform aimed at managing general population wellness and
prevention of cardiovascular disease
• Condition Management Program• Digital Patient Engagement platform to manage specific forms of cardiovascular disease (e.g., CHF, AMI,
Stroke, etc.) as a supplement to providers’ care
Health Motivation Platform
Current strategy
Science Technology
Behaviors
